<div class="feedback [(#ENV{config}|table_valeur{ajax}|=={1}|?{ajax})]">
<h3><:formulaire_feedback:feedback:></h3>
<form action="#ENV{action}" method="post" class="form_#FORM [(#ENV{config}|table_valeur{google_analytics}|=={1}|?{google-analytics-form})]" enctype="multipart/form-data">
    <fieldset>
    [<div class="erreur">(#PDK_MESSAGE_ERROR{#FORM})</div>]
    [<div class="message-ok">(#PDK_MESSAGE_OK{#FORM})</div>]
    #ACTION_FORMULAIRE{#ENV{action}}
    <div>
        <label for="name"><:formulaire_feedback:name:></label>
        <input type="text" id="name" name="name" value="#ENV{name}" />
        [<span class='erreur'>(#ENV**{erreurs}|table_valeur{name})</span>]
    </div>
    <div>
        <label for="email"><:formulaire_feedback:email:></label>
	   <input type="text"  id="email" name="email" value="#ENV{email}" />
       [<span class='erreur'>(#ENV**{erreurs}|table_valeur{email})</span>]
    </div>    
    <div>
        <label for="phone"><:formulaire_feedback:phone:></label>
	   <input type="text"  id="phone" name="phone" value="#ENV{phone}" />
       [<span class='erreur'>(#ENV**{erreurs}|table_valeur{phone})</span>]
    </div>
    <div>
        <label for="text"><:formulaire_feedback:text:></label>
		<textarea name="text" id="text" cols="10" rows="10">#ENV{text}</textarea>
        [<span class='erreur'>(#ENV**{erreurs}|table_valeur{text})</span>]
    </div>
    
    [(#REM)Insert upload files block]
    <INCLURE{fond=inc/feedback_files_upload}{env}>
    
    [(#REM)Insert captcha block]
    <INCLURE{fond=inc/feedback_captcha}{env}>
    
  <input type="submit" class="submit" value="<:formulaire_feedback:send:>"/>
</fieldset>
        			                 </form>
</div>